MacDonald T T, Spencer J
Department of Pediatric Gastroenterology, St. Bartholomew's Hospital, London, England.
Gastroenterol Clin North Am. 1992 Jun;21(2):367-86.
Epithelial adaptation clearly occurs during the course of intestinal cell-mediated immune responses to alloantigens. The adaptive response is similar to that seen in a number of enteropathies, namely villus atrophy, crypt hypertrophy, and crypt cell hyperplasia. In human fetal gut, polyclonal activation of lamina propria CD4+ T cells produces the same epithelial adaptive responses. Although these data provide overwhelming evidence that cell-mediated immune responses can cause enteropathy, the demonstration of antigen-specific T cells in the lamina propria of patients with enteropathy is still lacking, even in a disease as well-characterized as celiac disease. Epithelial adaptation in experimental and clinical situations, however, must involve a change in the mechanisms and mediators involved in normal intestinal homeostasis, such as epidermal growth factor and transforming growth factor-alpha and -beta, and in the interactions between epithelial cells and the underlying stromal cells.
上皮适应性显然发生在肠道细胞介导的针对同种异体抗原的免疫反应过程中。这种适应性反应类似于在多种肠病中所见的反应，即绒毛萎缩、隐窝肥大和隐窝细胞增生。在人类胎儿肠道中，固有层CD4 + T细胞的多克隆激活会产生相同的上皮适应性反应。尽管这些数据提供了压倒性的证据表明细胞介导的免疫反应可导致肠病，但即使在像乳糜泻这样特征明确的疾病中，仍缺乏在肠病患者固有层中存在抗原特异性T细胞的证据。然而，实验和临床情况下的上皮适应性必然涉及正常肠道稳态所涉及的机制和介质的变化，例如表皮生长因子、转化生长因子-α和-β，以及上皮细胞与下层基质细胞之间的相互作用。
